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From the 1/14/2022 release of VAERS data:

This is VAERS ID 932709

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Case Details

VAERS ID: 932709 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Unknown  
Location: Texas  
Vaccinated:2021-01-05
Onset:2021-01-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Chills, Feeling cold
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: pickles, cheese, sulfa drugs
Diagnostic Lab Data: B/P 141/100 PR 96 AT 1:10
CDC Split Type:

Write-up: PATIENT FELT COLD (CHILLS) ,. PATIENT REFUSED EMERGENCY SERVICES AND/ OR TO CONTACT A DOCTOR.


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